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General NPI Number Information
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NPI Number | 1043668858
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Entity Type | Individual
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Provider Name | JESSICA CADETTE BCBA-D, ED.D.
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Gender | Female
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Dates
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Enumeration Date | 06/02/2016
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Last Update Date | 06/02/2016
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Provider Practice Location Address
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Address Line | 5100 N NOB HILL RD
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City | SUNRISE
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State | FL
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Zip | 33351
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Country | US
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Telephone | 954-449-2422
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Fax |
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Provider Business Mailing Address
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Address Line | 7001 ENVIRON BLVD APT 107
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City | LAUDERHILL
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State | FL
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Zip | 33319-4273
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Country | US
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Telephone | 754-224-9730
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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